Operational cash flow remains severely constrained, highlighted by a 2026Q1 working capital outflow of $61.7 million and an OCF/NI ratio of -22.46, reflecting a persistent inability to convert earnings into cash.
| Cash from Operations | -85.24M | -91.24M | -110.13M | -76.03M | -126.02M | -66.47M | -24.6M | -28.29M |
| Operating CF Margin % | - | -6.25% | -7.34% | -6% | -12.01% | -10.43% | -5.01% | -19.44% |
| Operating CF Growth % | 42.44% | 17.15% | -44.85% | 39.67% | -89.58% | -170.25% | 13.05% | - |
| Net Income | -126.25M | -319.04M | -310.38M | -186.43M | -270.13M | -156.48M | -31.41M | -41.97M |
| Depreciation & Amortization | 84.19M | 84.16M | 86.06M | 86.67M | 87.29M | 8.72M | 795.17K | 399.18K |
| Stock-Based Compensation | 3.61M | 5.58M | 5.75M | 5.98M | 0 | 0 | 447.48K | 474.04K |
| Deferred Taxes | 3.35M | 2.87M | -1.09M | 0 | 0 | 0 | 0 | 6.36M |
| Other Non-Cash Items | 61.17M | 53.28M | 21.55M | -12.55M | 22M | 5.51M | -21.02M | -1.62M |
| Working Capital Changes | 22.36M | 81.91M | 87.98M | 30.3M | 34.82M | 75.78M | 26.59M | 8.07M |
| Change in Receivables | -28K | 26.38M | -3.76M | -41.99M | -27.18M | 448.15K | -27.37M | 424.14K |
| Change in Inventory | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Change in Payables | 46.17M | 58.07M | -8.1M | 15.99M | 46.39M | 68.76M | 8.1M | 803.5K |
| Cash from Investing | 86K | 129K | 14.53M | -1.83M | -7.73M | -56.07M | -3.17M | -3.86M |
| Capital Expenditures | 79K | 79K | 0 | -1.83M | -2.23M | -3.41M | -2.93M | -1.45M |
| CapEx % of Revenue | 0.01% | 0.01% | - | 0.14% | 0.21% | 0.54% | 0.6% | 1% |
| Acquisitions | 0 | 0 | 0 | 0 | -5.5M | -52.87M | -130K | 0 |
| Investments | - | - | - | - | - | - | - | - |
| Other Investing | 7K | 50K | 14.53M | 0 | 0 | 213.95K | -109.53K | -2.4M |
| Cash from Financing | 69.96M | 72.81M | 98.77M | 100.33M | 11.38M | 223.47M | 34.76M | 63.62M |
| Debt Issued (Net) | 71.14M | 72.81M | 58.95M | 14.1M | 11.38M | 28.16M | 34.94M | 1.58M |
| Equity Issued (Net) | 0 | 0 | 0 | 86.59M | 0 | 195.31M | -180K | 62.04M |
| Dividends Paid | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Share Repurchases | 0 | 0 | 0 | 0 | 0 | 0 | -180K | 0 |
| Other Financing | -1.18M | 0 | 39.82M | -364K | 0 | 0 | 0 | 0 |
| Net Change in Cash | -15.19M | -18.3M | 3.17M | 22.48M | -122.38M | 100.93M | 7M | 31.48M |
| Free Cash Flow | -85.16M | -91.16M | -110.13M | -77.86M | -128.25M | -69.88M | -27.52M | -29.74M |
| FCF Margin % | -5.78% | -6.25% | -7.34% | -6.15% | -12.22% | -10.96% | -5.6% | -20.44% |
| FCF Growth % | 31.08% | 17.22% | -41.45% | 39.3% | -83.53% | -153.91% | 7.45% | - |
| FCF per Share | -10.12 | -27.89 | -37.46 | -41.02 | -154.23 | -84.04 | -34.81 | -62.49 |
| FCF Conversion (FCF/Net Income) | 0.67x | 0.62x | 0.81x | 1.32x | 0.47x | 0.42x | 0.78x | 0.67x |
| Interest Paid | 0 | 0 | 14.19M | 5.81M | 0 | 0 | 685.42K | 0 |
| Taxes Paid | 0 | 0 | 5.48M | 567K | 0 | 0 | 0 | 0 |
Liquidity and underwriting failure
As reported in quarterly financial statements, PIII exhibits a chronic inability to convert net income into operating cash flow, evidenced by a volatile OCF/NI ratio that reached -22.46 in 2026Q1, suggesting that accounting losses significantly understate the actual cash burn required to sustain the current business model.
The consistent divergence between net income and operating cash flow indicates that non-cash items and working capital swings are masking the severity of the underlying cash drain. Investors should monitor whether this gap reflects aggressive accrual accounting or simply the inherent difficulty of managing medical claims liabilities in a high-utilization environment.
Based on the provided cash flow data, PIII has maintained a consistently negative free cash flow trajectory, with quarterly outflows reaching as high as $57.2 million in 2024Q4, underscoring the company's inability to achieve self-sustaining operations despite its significant scale in the Medicare Advantage market.
The persistent negative FCF margins, which have remained deep in the red throughout the observed period, suggest that the company's growth strategy is fundamentally capital-consumptive rather than value-accretive. This trajectory appears to leave little room for error, as the lack of positive cash generation necessitates constant reliance on external funding sources.
According to recent SEC filings, PIII's working capital dynamics are highly erratic, with a massive $61.7 million outflow in 2026Q1 alone, indicating that the timing of medical claims settlements and premium receipts is creating significant, unpredictable pressure on the company's already limited cash reserves.
The extreme swings in working capital suggest that the company is struggling to synchronize its cash inflows from CMS with the outflow of medical claims payments. This volatility appears to be a primary driver of the company's liquidity risk, as any delay in reimbursement or spike in claims can rapidly deplete available cash.
Based on the analysis of cash flow statements, the company's reliance on stock-based compensation and significant depreciation charges obscures the true cash cost of operations, as these non-cash adjustments fail to offset the underlying operational cash burn that continues to erode the company's balance sheet.
While stock-based compensation provides a minor non-cash buffer, it does not address the fundamental issue of negative medical margins. Analysts should be wary of interpreting these adjustments as signs of operational efficiency, as they appear to be secondary to the primary challenge of managing high-risk patient populations.
Quick answers to the most common questions about buying PIII stock.
P3 Health Partners Inc. (PIII) generated $-91.2M in net cash from operating activities in 2025. This reflects the cash generated directly from core business operations.
P3 Health Partners Inc. (PIII) reported negative free cash flow of $91.2M in 2025, indicating capital requirements exceeded cash from operations.
P3 Health Partners Inc. (PIII) spent $0.1M on capital expenditures in 2025. CapEx represents the cash invested in physical assets like property, plant, and equipment to maintain or grow the business.